NICE has recommended two new non-invasive diagnostic tests — including an endometriosis saliva test — for early NHS use, offering hope to women facing an average nine-year wait for diagnosis
A “game-changing” saliva test will be rolled out across the NHS to aid endometriosis diagnosis – bringing fresh hope to women facing a typical nine-year delay. The National Institute for Health and Care Excellence (NICE), the independent organisation advising the NHS on treatments, has backed two innovative non-invasive diagnostic tests for early NHS deployment.
Draft guidance published today (7 July) confirms doctors can now utilise Endotest, which examines saliva samples for minute biological markers known as microRNAs that may signal endometriosis is likely present.
A second newly-approved test, EndoSure, identifies endometriosis by measuring electrical signals in the digestive system using sensor pads placed on the stomach, following a 45-minute procedure where patients fast and consume water. Both tests will receive NHS funding while researchers gather additional evidence on their effectiveness.
Endometriosis, a debilitating condition where tissue similar to the womb lining develops elsewhere in the body, affects approximately one in ten women of childbearing age across the UK, with average diagnosis taking over nine years.
Presently, diagnosis requires a laparoscopy performed under general anaesthetic, involving insertion of a miniature camera through a small incision in the abdomen to examine the pelvis for indicators of the condition. Announcing the new tests, NICE healthtech programme director Dr Anastasia Chalkidou said: “A diagnosis of endometriosis can for some women take the best part of a decade, with the UK average standing at nine years and four months, and rising to 11 years for those from ethnically diverse communities.
“That delay means living with chronic pelvic pain that affects daily life, relationships and work. These technologies have the potential to change that by giving primary care professionals better non-invasive tools to identify endometriosis earlier allowing earlier and better treatment.
“Our draft guidance reflects our commitment to getting promising innovations to patients quickly, while making sure the evidence to support their wider use is built in a rigorous way.”
Ami Robertson, 23, first noticed endometriosis symptoms at just 16, yet was repeatedly dismissed and told she was suffering from irritable bowel syndrome. She was ultimately diagnosed through the non-invasive tests, finally allowing her to receive proper treatment.
The Pilates instructor, from Glasgow, said: “I spent years being told my pain was something else entirely. I started to doubt myself, wondering if it was all in my head. When I finally had the test, it took less than an hour and gave me something I’d never had before: concrete evidence I could take to my doctor.
“For the first time, I was believed, and I could finally get the help I needed. Today, my quality of life is night and day compared to before. No one should have to wait years to be believed.”
Simran Chavda, 15, first began suffering from severe pelvic pain at the age of 13, yet repeated visits to her GP and A&E failed to pinpoint the cause. Her mother Sharan Uppal, herself a GP, said the non-invasive test finally provided the evidence required to push for a referral and, ultimately, a diagnosis of widespread endometriosis.
Simran, from Huddersfield, said: “Getting my diagnosis honestly felt like the best thing in the world.
“The test itself was easy, it wasn’t painful at all – just drinking water and being monitored. Really simple. And I’m already starting to feel better after my surgery. I know it’s never going to go away completely, but I know I’m not going to be in pain all the time, and that means everything.”
Mum Sharan, 46, added: “We were hitting roadblocks everywhere. I lost count of how many times I took Simran to the GP. We ended up in AandE three or four times, spending over ten hours on one occasion, and nobody would take ownership. When the test came back strongly positive, it gave me the empowerment to go back to our GP and push for a referral.
“That test opened doors for us to get Simran the help she needed at a time when NHS waiting times meant we couldn’t afford to wait. I would recommend it to anyone.”
Endometriosis symptoms include heavy menstrual bleeding, fatigue, pain when urinating, pelvic pain, difficulty conceiving and painful bowel movements. For Ebony Dowdell, 20, whose periods lasted as long as four months, it took eight years to receive a diagnosis and treatment for her condition.
She underwent a laparoscopy procedure in July 2024 but still wasn’t officially diagnosed until she consulted additional specialists. Ebony, from Southampton, had robotic assisted endometriosis excision laparoscopy surgery to remove her endometriosis in April 2025, at a cost of over £20,000.
“If I had a quicker diagnosis I don’t think it would have got to that point,” she said. “If I had been seen quicker and I had a diagnosis, I would have not felt as alone. It is so lonely.
“Having a diagnosis makes you feel human, you know it is not in my head and you are not crazy. I think a quicker diagnosis system would make a huge difference to people, younger people would be getting diagnosed earlier too.”
The Endotest works by examining a saliva sample to identify biological markers linked to endometriosis. The sample is collected and dispatched to a laboratory for testing, before the result is passed back to the healthcare professional to help determine the next steps in diagnosis and treatment.
EndoSure identifies endometriosis by measuring electrical signals in the gut via sensor pads positioned on the abdomen. Patients are required to fast for six to eight hours beforehand, and throughout the 45-minute procedure are asked to drink water until full, enabling the device to accurately record gut activity.
Results are available the moment the test is complete.
Dr Gail Busby, consultant gynaecologist at Manchester University NHS Foundation Trust, said: “These tests are a game-changer because they give us answers much earlier, without the need for invasive surgery, and that means we can start the right treatment sooner. An earlier diagnosis doesn’t just change one person’s life, it frees up appointments and surgical slots for everyone waiting for care.”
A survey of more than 10,000 women living with the condition revealed that over half reported visiting their GP more than ten times before finally receiving a diagnosis, according to the All-Party Parliamentary Group. Both new tests are designed to support diagnosis, referral and management, and are not intended to serve as standalone diagnostic tools.
They should furthermore only be used in women where endometriosis remains suspected despite a normal clinical examination, and must be carried out by a qualified healthcare professional.
